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Abnormal Psychology > Chapter 9 - Schizophrenia > Flashcards

Chapter 9 - Schizophrenia Flashcards

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1
Q

What are some common misconceptions about schizophrenia?

A
  1. means someone has two personalities

2. that they are violent

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2
Q

Schizophrenia

A

a chronic disorder characterized by disturbed behaviour, thinking, emotions and perceptions

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3
Q

What is the hallmark of schizophrenia?

A

psychosis: significant loss of contact with reality

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4
Q

How is schizophrenia heterogenous?

A

Those with the disorder can differ widely in symptoms, background, response to treatment, ability to live outside the hospital, etc.

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5
Q

What percent prevalence of Schizophrenia is there in North America and Europe?

A

1% of the population

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6
Q

How many people suffer from schizophrenia worldwide?

A

Approx. 24 million

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7
Q

At what age to psychotic symptoms typically appear?

A

Mid 20’s for men. Late 20’s for women

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8
Q

Are there different levels of risk between genders?

A

Equal gender risk, but men display more symptoms earlier and more severely than women

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9
Q

How fast is the onset of schizophrenia?

A

Most often it is a slow, gradual decline in functioning. Sometimes it is acute and can lead to an acute psychotic episode within weeks

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10
Q

Prodromal phase

A

The period of gradual deterioration

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11
Q

Acute/Active Phase

A

The individual is experiencing an active psychotic episode

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12
Q

Residual phase

A

The phase following an acute phase: return to the level of functioning in the prodromal phase. No psychotic behaviour but still significant impairment

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13
Q

When does the historical evidence for schizophrenia begin?

A

Late 18th century

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14
Q

What is missing from descriptions of ‘madness’ (thought to include schizophrenia) prior to the 1700’s?

A

accounts of auditory hallucinations - common to about 70% of schizophrenia patients

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15
Q

What are the DSM 5 criteria for schizophrenia?

A
  1. 2 or more of these symptoms in a 1 month period:
    - delusions
    - hallucinations
    - disorganized speech
    - grossly disorganized or catatonic behaviour
    - negative symptoms
  2. Continuous symptoms for min. 6 months. Dysfunction in normal living
  3. Symptoms not better explained by substance abuse or other condition
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16
Q

Do people with briefer forms of psychosis receive a diagnosis of schizophrenia?

A

No, they are given other diagnoses such as brief psychotic disorder

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17
Q

Positive symptoms

A

excess or distortion of one’s normal behaviour and thoughts

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18
Q

What are some positive symptoms of schizophrenia?

A 
Delusions
Hallucinations
Disorganized speech
Disorganized behaviour
(all involve a break with reality)
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19
Q

Negative symptoms

A

a lack or deficit of normal behaviour and thoughts

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20
Q

What are some negative symptoms of schizophrenia?

A

Blunted emotional expressiveness
Alogia - poverty of speech
Avolition - lack of drive/motivation

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21
Q

What are the most common types of delusions a schizophrenic experiences?

A

Persecutory
Referential
Somatic
Delusions of grandeur

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22
Q

Persecutory delusions

A

the belief that others are ‘out to get you’

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23
Q

Referential delusions

A

Believing that others are reacting to you. ie. people on TV are making fun of me

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24
Q

Somatic delusions

A

believing that one’s thoughts, feelings, impulses or actions are controlled by external forces, such as agents of the devil

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25
Q

Delusions of grandeur

A

believing oneself to be God or on a special mission

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26
Q

What are some common schizophrenic delusions related to thoughts?

A

thought broadcasting - others can hear your thoughts
thought insertion - thoughts have been planted
thought withdrawal - thoughts have been removed

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27
Q

Hallucinations

A

sensory perceptions occurring in the absence of external stimuli that become confused with reality. Can involve any of the senses

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28
Q

What are the most common schizophrenic hallucinations?

A

Auditory
Tactile
Somatic

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29
Q

Auditory hallucinations

A

hearing voices - experienced by 70% of schizophrenics

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30
Q

Tactile hallucinations

A

tingling, electrical or burning sensations

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31
Q

Somatic hallucinations

A

Specific body-related ie. ‘there are snakes crawling in my belly’

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32
Q

Visual hallucinations

A

seeing things that are not there

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33
Q

Gustatory hallucinations

A

tasting things that are not present

34
Q

Olfactory hallucinations

A

smelling things that are not present

35
Q

Command hallucinations

A

voices telling you what to do ie. harm yourself or others

36
Q

What are the suspected causes of hallucinations?

A

Disturbances in brain chemistry including the neurotransmitter dopamine

37
Q

How can drugs such as cocaine induce hallucinations?

A

Drug use can lead to increased production of dopamine

38
Q

What characteristics of thought and speech are common in schizophrenics?

A

distortions in thinking and expression of thoughts through coherent, meaningful speech

39
Q

Thought disorder

A

a disturbance in thinking characterized by the breakdown of logical associations between thoughts

40
Q

How do attentional deficiencies affect a schizophrenic’s ability to to learn and think?

A

causes them to have difficulty filtering out irrelevant stimuli ie. can’t focus attention, organize thoughts or filter out unessential information

41
Q

Flat effect

A

negative symptom: absence of emotional expression in the face and voice

42
Q

Alogia

A

negative/emotional disturbance: a deficit or reduction in communication

43
Q

Avolition

A

negative/emotional disturbance: lack of motivation; inability to initiate and persevere in activities

44
Q

Andomonia

A

negative/emotional disturbance: loss of pleasure, don’t enjoy the things you used to

45
Q

What happens when a schizophrenic suffers from loss of ego boundaries?

A

Confusion about personal identity

Failure to see oneself as a unique individual

46
Q

Catatonia

A

people with schizophrenia become unaware of the environment and maintain a fixed or rigid posture

47
Q

Waxy flexibility

A

when an individual allows body and limbs to be moved and then retains the new position

48
Q

What changed in the DSM 5 diagnoses of schizophrenia as compared to the DSM-IV-TR?

A
  1. one of the three positive symptoms must be present

2. Subtypes were eliminated

49
Q

Endophenotypes

A

measurable processes or mechanisms not apparent to the naked eye. The means by which an organism’s genetic code affects observable characteristics or phenotypes

50
Q

What possible endophenotypes are being explored as correlated to schizophrenia?

A

disturbances in brain circuitry
deficits in working memory
impaired attentional/cognitive processes
abnormality in neurotransmitter function

51
Q

Eye movement dysfunction is common in people with schizophrenia and…

A

their first degree relatives. Suggests a biomarker - genes linked to schizophrenia

52
Q

How is schizophrenia explained from a psychodynamic perspective?

A

The ego is overwhelmed by primitive sexual or aggressive impulses from the id. These impulses threaten the ego and lead to intense intrapsychic conflict

53
Q

Which Freudian stage does a person facing schizophrenia revert to?

A

The oral stage. Also called primary narcissism

54
Q

How is schizophrenia partially explained from a learning theory perspective?

A

Bizarre behaviours are learned when they are more likely to be reinforced than normal behaviors

55
Q

Do first degree relatives of people with schizophrenia have a different risk level of developing it themselves?

A

Yes, ten times mores than the general population

56
Q

What mechanisms may be critical in making schizophrenia related genes active?

A

Epigenetic mechanisms

57
Q

What prenatal factor may be linked to schizophrenia?

A

viral prenatal infections show possible links to increased risk of schizophrenia

58
Q

What is the most prominent structural abnormality found in persons with schizophrenia?

A

Loss of brain tissue (grey matter)

59
Q

In what area of the brains of people with schizophrenia has abnormal function and loss of brain tissue been found?

A

the prefrontal cortex

60
Q

What is the leading biochemical model of schizophrenia?

A

the dopamine hypothesis: suggests schizophrenia involves an over reactivity of dopamine transmission in the brain

61
Q

What is the major source of evidence for the dopamine hypothesis for schizophrenia?

A

the effects of antipsychotic drugs called neuroleptics

62
Q

How is a negative family environment linked to schizophrenia?

A

Those with a genetic vulnerability could be more likely to develop schizophrenia if they are in a negative/stressful family/social environment

63
Q

Communication Deviance (CD)

A

a pattern of unclear, vague, disruptive or fragmented communication found in the families of schizophrenia patients

64
Q

What are the forms of disturbed family communication that can contribute to the development of schizophrenia?

A

Communication Deviance

Expressed Emotion

65
Q

Expressed Emotion

A

a pattern of responding to the schizophrenic family member in hostile, critical and unsupportive ways

66
Q

How is Expressed Emotion related to schizophrenia patients?

A

High EE families are less tolerant and flexible.

Patients from high EE families stand a higher risk of relapsing

67
Q

How does the Diathesis-stress model view the development of schizophrenia?

A

as an interaction of a genetic predisposition (diathesis) with stress life factors. Especially environmental stress such as family conflict, child abuse, emotional deprivation or brain trauma/injury

68
Q

What is the biological approach to the treatment of schizophrenia?

A

The use of antipsychotic medication to control the flagrant behaviours that disrupt normal life such as delusional thinking and hallucinations. Reduces the need for long-term hospitalization

69
Q

How do antipsychotic drugs treat schizophrenia?

A

They block dopamine receptors in the brain, reducing dopamine activity and quelling more obvious symptoms. ie. hallucinations, delusions

70
Q

What aspects of schizophrenia does treatment with antipsychotics not address?

A

Does not address negative symptoms and cognitive impairments

71
Q

What was Freud’s belief on the use of psychoanalysis in the treatment of schizophrenia?

A

Traditional psychoanalysis is not suited to treatment. The client withdraws to a fantasy world and can’t form a meaningful relationship with the psychoanalyst

72
Q

What problems does Cognitive Behavioral Therapy focus on in the treatment of schizophrenia?

A

Emotional disturbance
Psychotic symptoms
Social disabilities
Risk of relapse

73
Q

What does the CBT model include in treating schizophrenia?

A

How to interpret environmental events
How to respond to social cues
Practice dealing with positive symptoms

74
Q

What are the Learning-Based Therapy methods in treating Schizophrenia?

A

Reinforcement of behaviour
Token economy
Social skills training

75
Q

What is ‘reinforcement of behaviour’?

A

A learning-based therapy model that provides or withdraws attention according to the appropriateness of the patient’s behaviour

76
Q

What is ‘token economy’?

A

A learning-based therapy model that rewards appropriate patient behaviour with tokens that can be exchanged for goods or privileges

77
Q

What is ‘social skills training’?

A

A learning-based therapy model in which clients are taught conversational skills and other good social behaviours through coaching, modelling, behaviour rehearsal and feedback

78
Q

How do Family Intervention Programs assist in treatment of schizophrenia?

A

Families are trained in coping with the burden of care and developing cooperative, less-confrontational ways of relating. This reduces stress and risk of relapse for the patient.

79
Q

What are other disorders that are on the Schizophrenia Spectrum?

A

Brief psychotic disorder - lasts a day to a month following a major stressor
Schizphreniform Disorder - last less than 6 months w/ similar features
Delusional disorder - people who hold persistent, delusional and often paranoid beliefs

80
Q

What are some other forms of psychosis?

A

Erotomania - rare, one believes that they are loved by someone famous or important
Schizoaffective disorder - individuals who experience both severe mood disturbance and features associated with schizophrenia

Abnormal Psychology (8 decks)

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